CPT code 26580 is used to describe the surgical repair of a hand deformity, detailing the specific procedure performed.
CPT code 26580 is used to describe the surgical procedure for repairing a hand deformity. This code specifically refers to the correction of structural abnormalities in the hand, which may involve the reconstruction of tendons, ligaments, or other soft tissues to restore function and improve the appearance of the hand. This procedure is typically performed by a hand surgeon and may be necessary due to congenital issues, trauma, or other conditions affecting hand function.
When billing for CPT code 26580 (Repair hand deformity), the following modifiers may be applicable, depending on the specific circumstances of the procedure:
1. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both hands.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if multiple procedures are performed during the same session.
3. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional: Use this modifier if the procedure is part of a staged treatment plan.
4. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is applicable if a return to the operating room is necessary due to complications related to the initial procedure.
5. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: Use this modifier if a separate, unrelated procedure is performed during the postoperative period of the initial procedure.
6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used if the same procedure is performed again on the same day.
7. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
8. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period: This modifier is appropriate if an evaluation and management service is provided during the postoperative period that is unrelated to the procedure.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and compliance with payer requirements.
The CPT code 26580 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, reimbursement for CPT code 26580 may vary depending on the local policies set by the Medicare Administrative Contractor (MAC) for your region. Therefore, it is advisable to consult the MPFS and your regional MAC to confirm the current reimbursement status and any specific billing requirements for CPT code 26580.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level and by individual payer. For instance, with CPT code 26580, you can ensure that you are receiving the correct reimbursement for your services. Schedule a demo today to see how RevFind can help you identify and address underpayments effectively.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
